Abstract
s A e D f z t t d i Direct percutaneous endoscopic jejunostomy (DPEJ) tube placement is indicated in patients who require prolonged enteral feeding but are not suitable candidates for PEG or when attempted PEG placement fails. Although PEG with transgastric jejunal tube extension (PEG-J) is another option, the delivery rate of enteral feeds is limited by the narrowbore extension tube, which is also prone to frequent obstruction and migration back into the stomach. Furthermore, PEG-J may not decrease the risk of recurrent aspiration pneumonia as has been shown with DPEJ.3 However, DPEJ is technically challenging, with lower rates of successful placement than PEG. DPEJ is usually performed by using colonoscopes or push enteroscopes,
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